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Home My WebLink AboutFIRE LAKE BLK 3 LT 1AFire Lake Block 3 Lot 1 A #051-361-23 Dec 11 18 10 17a Anchongs MH & Pump S -i -,072430742 P 1 bevelopment 57,ervices Departrneo- Building 5afety Divi'sion 61, 1 On -Site Water & Wastewater Prograr, P.O. Box 196650 U� Wk Byth Anhcrna, AN 99507 Mayor Purnp Installation Uy W01 Kiril Ag PnnnR Numb"I SAI Dated Issue Parcel Identirwat-joij jjjtjlj)uj-; 0 Ler-A De,,;ciiptior, Property Ow)el, N4,7TIf, 8 L(A A, PuITIP Wakt Deptli Belo�i Top of IV4L,11 fee( Pally MAylufaclurel-'s Name: P f! - +— PjtjC,SS.-kdttPtLr Burial Depr!-i- i Leet Men Ad*kr Manu btower's Name: f0wanow- PitleSS Adapter -1:1SU'ller' Well Diinfected Up r. Compknn? lis N p':? of Mulakn,. Comments; P-�-Ikv �- _,ktteRfiOIr Thpuirp, insWur shall PMA& a PMT haybdol tog to die I)SD, W."thill]'Odays c-rj-vUj--,IP inspection Nepoa_i-i-iz.aoc/ Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Iwww.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141505 PID Number: '151-361-23 ❑ New ❑✓ Upgrade Name: Michael Kish & Tonya Wilson-Kish ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench El Bed El Mound Address 13810 Malaspina St. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/5F 9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5 Ft., Gravel depth beneath pipe 4Ft. Subdivision - Fire Lake Block Lot 3 1A Fill added above original grade 0 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 500 Ft2i Number of trenches 1 Dist. between trenches Ft. Well N/A 100.4 NA NIA TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water NIA 100+ N/A N/A Gal. Material Number of compartments Lot Line NIA 62.7 N/A N/A NA Foundation N/A 23.7 N/A I N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A 50+ N/A t NIA Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank Tank to drainfield 3034 JR's Septic Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection is' 12/2/2014 dates: 3" 12/3/2014 2" a 12/3/2014 41" Location and description Top of Deck Nearest Tank COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date .. �q�lp1�1 . ... . ..... eve n"ti' `Konno ae' X 12/' W Approved Date aI ma/y }l r�1A� inspection Nepoa_i-i-iz.aoc/ WELL (E) I/ WELL (E) !'IAC LAREN STREET - W \ � �a� W �yJ � \ 1w WELL (E) -77 1_11� L 0 T I A, 101.4 3A DRIVEWAY WELL (E) Col MTI 1102.5 4BR HOUSE Ate) y' ,I TH- I C CO2 TI W� E) MT2 11250g SEPTIC TANK (E) UPGRADED DRAIN FIELD � , &s TI VERIFIED INTEGRITY AND 5OLF x 3'W x 4.0'ED x 9.0'TD Dcl REPAIRED STAND PIPES INSTALLED DCO AND DV DOG ENCLOSURE DC2DV 10' UTILITY EASEMENT /V N\: 41 SEPTIC AREA (E) 3AWELL(E) 4-5- JA;' NOTES: PAMONE ENG SVC, LLC RECORD DRAWING P.D. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, BLOCK 3, LOT IA MICHAEL KISH & TONYA WILSON-KISH 13810 MALASPINA STREET PLAN EAGLE RIVER, AK 99577 wX Is I ftli � 107 =I Steven R. Pon c.ne • CE 8149 Dote 12/15/14 Scale 1"=50' P.I.D. NO 051-361-23 DERMIT NO A B C T1 35.30 23.70 T2 39.90 30.0 DC 1 40.40 32.1 DC2 40,60 32.6 DV 40.80 33.1 C 1 55.20 48,60 M 1 55,00 50A0 C2 26.0 81 Ei2 27.6 8_240 wX Is I ftli � 107 =I Steven R. Pon c.ne • CE 8149 Dote 12/15/14 Scale 1"=50' P.I.D. NO 051-361-23 DERMIT NO SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATERDISPOSALSYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. INSTALLED NEW DRAIN FIELD. VERIFIED CONDITION OF EXISTING 1250g SEPTIC TANK. 3. GROUNDWATER WAS NOT ENCOUNTERED AT TO A DEPTH OF 15 FEET BELOW EXISTING GRADE. NO WATER TABLE WAS OBSERVED IN THE EXCAVATIONS LESS THAN 1.7 FEET BELOW EXISTING GRADE. FILTER FABRIC - 4' 0 DRAIN PIPE ROCK 6" ABOVE PIPE INV -1.0 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO, BEDROOM: 4 (600 gpd) TANK SIZE: 12508 PERC RATE: 1.7 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 4.O'ED MIN LENGTH: 50 LF USED: 50 LFx5.0'Wx4.0' E.D., 9.0' TD TOTAL AREA: 500 SF LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE GW/ 86.1 FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. Gm GM DRAIN ROCK CLEAN OUT NO. M# Iv1GNITOR TUBE NO. 4.0 RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE 6.0 SECTION NOT IN CONTRACT -15.0 76.1 > o F� > o a j > w o wo w w m a� gw s o w w w 0 s s C < O Z H Q DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO, BEDROOM: 4 (600 gpd) TANK SIZE: 12508 PERC RATE: 1.7 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 4.O'ED MIN LENGTH: 50 LF USED: 50 LFx5.0'Wx4.0' E.D., 9.0' TD TOTAL AREA: 500 SF LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# _ CLEAN OUT NO. M# Iv1GNITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NIC NOT IN CONTRACT NOTES: PANNONE ENG SVC LLC ��OF q ��SIz/"/14 Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 .: �� CI� PHONE (907) 272-8218 FAX (907) 272-8211 ig�p �y+� Scale NTS ...... ........ ...... P.I.D. NO FIRE LAKE, BLOCK 3, LOT 1A / 051-361-23 MICHAEL KISH & TONYA WILSON—KISH Steven R.'Pan'none'j PERMIT No. �'. CE 8149 �� OSP 141505 13810 MALASPINA STREET �+ �� . DESIGN DETAILS EAGLE RIVER, AK 99577 'iI� .....S..... '� Sheet On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141505 Tax Code Number: 05136123000 Work Type: Septic Upgrade Permit Effective Dates: November 25, 2014 to November 25, 2015 Design Engineer: PANNONE Subdivision: FIRE LAKE SERVICE Site Legal Address: FIRE LAKE BILK 3 LT 1A G:0453 Owner/Address: KISH MICHAEL L & WILSON-KISH TONYA V 13810 MALASPINA STREET EAGLE RIVER AK 995777504 Site Mailing Address: 13810 MALASPINA ST, Eagle River Lot Size in Sq Ft: 33300 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: Ut- Date: /I 261 k\ L RUSH! MUNICIPALITY OF ANCHORk6 mg #49& Community Development Department Phone: 907- -7 4 Development Services Division Fax: 907-343-A97 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel LD., 051-361-23 Property owner(s) Michail Kish & Tonya Wilson -Kish Day phone Mailing address 13810 Malaspina Street, Eagle River, AK 99577 Site address 18310 Malaspina Street Legal description (Sub'd., Block & Lot) Fire Lake, Block 3, Lot 1A Legal description (Township, Range & Section) Lot Size 33,300 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank INUpgrade ❑X Duplex (D) El Tank El Renewal ElDuplex Dwellings ElPrivy ❑ V MITTAI (SF and/or D) VV Private Well ❑ 11yy�� Water Storage ❑ NOV 14 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 5L61 — Date of Payment: I Iir7//q Receipt Number: lbySn rn Permit No. ©519141S6`5 Permit App_-'- :: [..,k, Waiver Fees: Date of Payment: Receipt Number: Waiver No. '-3q I , q r 1([7,/ Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: stevefti3anen¢ak.com November 14, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Rd. P. 0. Box 196650 Anchorage, -Alaska 99519 Subject: Fire Lake, Block 3, Lot 1A Well and Septic System Permit Request Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic system be issued for this property. The existing system is in failure and will be re -used as a reserve. The proposed systems will serve an existing four bedroom (4) bedroom house. Currently the lot is developed. The proposed system will utilize a 1250g septic tank with a conventional drain field. The surrounding lots are served by private wells and all are 100'+ from the proposed septic. 1. Soils. One test hole was performed by Pannone Engineering Services in November of 2014, and groundwater was monitored for seven days. Ground water was not observed to a depth of fifteen feet(15.0') below the ground surface after the seven day monitoring period. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional drain field. 2. Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100' of this system. 4. Topography: The existing topography slopes from east to west at approximately 5% in the area of the proposed drain field. There are no steep slopes in the vicinity of the drain field. 7. Drawing Markings:The Drawings are marked "For MoA Review Only". When writen notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 WELL (E) / 1 % �c4 WELL (E) z t3` / �PIAC LAREN STREET W W � w \ WELL (E) i 101.0 .3A / DRIVEWAY WELL (E)\ / 1 00.9 a l z SHED 4BR UPGRADE DRAIN FIELD (P) \ HOUSE a SOLE x 3'4V x 4.0'ED N(E)9.0'TD I _ W_Y w fly TH-1 �� 12309 SEPTIC TANK (E) VERIFY INTEGRITY AND REPLACE 1 WITH 72309 SEPTIC TANK (P) i IF FOUND TO BE LEAKING i DOG ENCLOSURE �� .J INSTALL DCO AND DV i 10' UTILITY EASEMENT ' S SEPTIC AREA (E) / zip M 3A WELL (E)A 3 I I F I NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION - P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, BLOCK 3, LOT to MICHAEL KISH & TONYA WILSON—KISH 13810 MALASPINA STREET PLAN EAGLE RIVER, AK 99577 n R. Pannone CE 8149 ��, 11/4/14 Scale 1 "= 50' P.I.D. NO 051-361-23 'ERMIT N0. OSP 141505 Sheet 1 OF 3 i i DRIVEWAY WELL (E)\ / 1 00.9 a l z SHED 4BR UPGRADE DRAIN FIELD (P) \ HOUSE a SOLE x 3'4V x 4.0'ED N(E)9.0'TD I _ W_Y w fly TH-1 �� 12309 SEPTIC TANK (E) VERIFY INTEGRITY AND REPLACE 1 WITH 72309 SEPTIC TANK (P) i IF FOUND TO BE LEAKING i DOG ENCLOSURE �� .J INSTALL DCO AND DV i 10' UTILITY EASEMENT ' S SEPTIC AREA (E) / zip M 3A WELL (E)A 3 I I F I NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION - P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, BLOCK 3, LOT to MICHAEL KISH & TONYA WILSON—KISH 13810 MALASPINA STREET PLAN EAGLE RIVER, AK 99577 n R. Pannone CE 8149 ��, 11/4/14 Scale 1 "= 50' P.I.D. NO 051-361-23 'ERMIT N0. OSP 141505 Sheet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALL NEW DRAIN FIELD. VERIFY CONDITION OF EXISTING TANK AND REPLACE WITH 1250g SEPTIC TANK IF FOUND TO BE LEAKING. 3. GROUNDWATER WAS NOT ENCOUNTERED AT TO A DEPTH OF 15 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15 FEET.BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. , FILTER FABRIC - 4" 0 DRAIN PIPE -15.0 - I w ziut 1250g SEPTIC TANK F_ DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM N0, BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE: 1.7 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 4.0'ED MIN LENGTH: 50 LF USE: 50 LFx5.0'Wx4.0' E.D., 9.0' TD TOTAL AREA: 500 OF - PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS NEW SEPTIC NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, BLOCK 3, LOT to MICHAEL KISH & TONYA WILSON-KISH 13810 MALASPINA STREET DESIGN DETAILS EAGLE RIVER, AK 99577 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE a m FOUNDATION CLEAN OUT T# TANK CLEAN OUT N0, C# CLEAN OUT N0. M# MONITOR TUBE NO. o > 0 > 0 > ,,, 0 DV > 0 0 a o <0 �zz BFG z mz ORIGINAL GRADE z I z TS&V w w -w > a o 0 00 �o 0 0 0o ziut 1250g SEPTIC TANK F_ DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM N0, BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE: 1.7 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: WIDE TRENCH 4.0'ED MIN LENGTH: 50 LF USE: 50 LFx5.0'Wx4.0' E.D., 9.0' TD TOTAL AREA: 500 OF - PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS NEW SEPTIC NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 FIRE LAKE, BLOCK 3, LOT to MICHAEL KISH & TONYA WILSON-KISH 13810 MALASPINA STREET DESIGN DETAILS EAGLE RIVER, AK 99577 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT N0, C# CLEAN OUT N0. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NIC NOT IN CONTRACT Date 11/24/14 *:49R %� *�� NTS ' "" P.LD. NO 051-361-23 Steven ?' Pannone PERMIT N0. IPF.•, CE 8749 .'�ej OSP141505 Vr FROFESS10C1PVE�• Sheet 2 OF 3 1 2 3 4 s s 7 8 s 10 11 12 13 14 15 16 17 18 19 TEST HOLE 1 OR ORGANICS WELL GRADED GW/ GRAVEL W/ GM SMALL AMOUNT OF SILT SOILS LOG - PERCOLATION TEST SLOPE X TH WAS GROUND WATER ENCOUNTERED? N BOH IF YES, AT WHAT DEPTH? -DRY DEPTH TO WATER AFTER MONITORING? -DRY DATE: 11/13/14 DATE PERFORMED: 11/06/14 1 DRIVEWAY - • SPED�`. 4ER � HOUSE I (E) W__�� STH -1 DOG ENCLOSURE�� -� 10' UTILITY EASEMENT � T f -- SLOPE TH X READING DATE CLOCK NETTIME WATERTIME LEVEL READING NET DROP 1 11/6/14 12:30 --- 5.23 --- 2 12:38 8 MIN 11.23 6.00 3 12:38 --- 5.23 --- 4 12:47 9 MIN 11.23 6.00 5 12:47 --- 5.23 --- 6 12:57 10 MIN 11.23 6.00 PEROLATION RATE 1.7 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 5 FT AND 66 FT COMMENTS: Test hole excavated by JR's SEPTIC PUMPING. Prec hole was PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: �7�7�� 7�7� 7�� `Q'�'J `�� \\� Date FOR CONSTRUCTION Pp p g�XO102954 EANCHORAbt, C, 99 L i � �LgcS'�� 11/24/14 PHONE (907) 272-8218 FAX (907) 272-8211 %g�p �yt) Scale 49H *l) NTS .... ..... .... P.LD. NO FIRE LAKE, BLOCK 3, LOT 1A ... .. .... „/ 051-361-23 MICHAEL KISH & TONYA WILSON—KISH Steven R. anno. I P, GE 8149 ,�� PERMIT NO. . r 13810 MALASPINA STREET �+ "ear OSP141505 3 OF 3 OS SOILS LOG EAGLE RIVER, AK 99577 1,1F�F��FE5S10NP�' Sheet ��>\ MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 - ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHH,Off(NE -N EW L� ' / 290 ❑ UPGRADE MAILING ADDRESS 90 D J ��•� LEGAL DESCRIPTION +� L , �� i�C�. alip _5 0/40 - LOCATION NO. OF BEDROOMS U Well 1 „', Absorption area DISTANCE TO: 1 z v.. �— � Dwelling 1 ., PE IT NO. 3 Y F-ZQ /fin / Manufacturer /� '�/ Mater' / �G No, of compartments W ~ /' . l Lic r.�pa gallons 'DISTANCE IF HOMEMADE: Inside length Width Liquid depth p 0 Y TO: Well " Dwellin g PERMIT NO. _ F Manufacturer Material Liquid capacity in gallons J= W DISTANCE TO: Well /� Z ,,,,j.- Foundation 7 a _G Nearest loj e /� / PERJ\AJ N�O.' 2jj J LL Z Lu ~ No. of lines Length of�.ach I fel / Total le h of hne# - Trench width/ inches Distance b e Ines Q F. ----- _ s�--LL- Top of tile to finish grade Materi bene t tile / fis�-�_�/�. �1 //inches 2- /'�4 Total effective absorption area l w Length Width Depth PERMIT NO. CL H Type of crib Crib diame er Crib depth Total effective absorption area N _ _ Building foundation__ Nearest lot line Well DISTANCE TO: J JWDISTANCE Class X / C epth +Drer Distance to lot line PERMIT NO. TO: Bilding foundationer line Septic tank Absorption areas) OTHER D G✓ �' PIPE MATERIALS -- SOILTEST RATING r -- INSTALLER FI-1-��,"— S-_�o-�j kilo -e OSS � Q S R,UIAB KIF /_/ `` / V �!_� �' -- so / --tea e - d awl cvr Robert A. Shof t,tl-- --- — � 00 No. l`!� APPR EP DATE LEGAL Z�` 41u of S & S Engine'(Ni CU I J knev. J/ /6/ �CZ:j k__ .� I -e I. .- 0�� HEALTH FIND 'FE CT10 I'l 825 'L' STREET/HNCHORHGE, HK 99501 264~4720 I-�E� �� F"11-1 I l� /7 PERMIT NO. ( 81059] ) HPPLICHNT BHCKHOE SRH 2 BOX 4]80 CHUGIHK 688~9280 LOCATION FISH HATCHER ROAD LEGHL LOT 1H BLK ] FIRE LAI SUB LOT SIZE 40000 SQUHRE FEET TYPE OF SOIL HBSORPTION SYSTEM IS: TRENCH MH�IMUM NUMBER OF BEDROOMS 4 SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �1 -4 � ��t-4�� '5m !:5 3 F-` f--1 U L �-Ir'"� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). �1E. C."! U I F;;� ICE- Cn ��- I C- �CA r--1 �I =- Ei� ��!ffv Cj (3 f -':o L_ L_ 11-1 VA �L PERMIT APPLICANT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF HNY WELLS ADJACENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ��_ �� I��4� V-1 IF;;? F��I�� ~~� BACKFILLING OF AN' -r' SYSTEM WITHOUT FINHL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON --SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MHY APPLY. SPECIFICATIONS HND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INSTALLATION. ��A F_�� Irl ED EHE� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS FORTH BY THE MUNICIPHLITY OF HNCHORHGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAI' THE ON~SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE 'THAN 4 BEDROOMS. SIGNED ISS�ED | AND WELLS HS SET ENLHRGEMENT IF THE V40 . 0 ...... ...... r v "Irl" �I� DEPHRTMENT . HEHLTH HND ENYIRONMENTHL �OTECT ION 825 'L' STREET. HNCHORHGE/ HK99501 264-4720 9 4 IL_. Il ll:`:� r -A ��J- ER* I - I E.'.:' F.--" F" E-Ei' F-? r-1 1 -T" PERMIT NO. ( 810674 ) HPPLICANT NELDON CONST 6917 OLD SEWHRC, ]49 6691 �OCHTION FIRELHKE S/D LEGAL L1A B] FIRE'LAKE S/D LOT SIZE 4]]00 SQUHRE FEET TYPE OF SOIL HBSORPTION SYSTEM TRENCH MHXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)1]7 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �IF-- 7- IF -1 ��J 1-+=L -4 ;2 ��_ ��F.:2�� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). ��L I I F. t F_ E.".��I C- �n Ir -4 V` -*:-71 1 2! ��...... ��r-,j� PERMIT APPLICHNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE ILRTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES 'THAT THE WELL WILL SERVE ��r, 1.4 C") < ;2 T r-4 F"-" 11 wD F -i r47-! IE--_ t -.l I F,:�. IEE F.. -fl _�_ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND APPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWEEN H WELL HND ANY ON-SITE SEWAGE DISPOSAL..SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICHTIONS AND CONSTRUCTION DIHGRHMS ARE HYHILHBLE TO INSURE PROPER INSTALLATION. 1 IF ��El' EK' r-1 Fw IEE F,�P :L�� I CERTIFY THHT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR OW -SITE SEWERS HND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES� ]� I UNDERSTHND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS, S5GNED: ...... APPLICHNT NST ~�DHTE__;4�0 SOILS LOG MUNICIPALITY OF ANCHORAGE ` •\� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST \ j 625 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLAT ION � TEST PERFORMED FOR: �� !'C SCS /'� /.�'�CC�z .Z� DATE PERFORMED: LEGAL DESCRIPTION: DEPTH F —S l� �� s' "g c a 3 4 5 6 v` i 1 7 40 8 9 11 I WAS GROUND WATER p ENCOUNTERED? 12 /1 C)F 40' 4 ,MF YES, AT WHAT r 13 •eN•w ✓fit;, •.•* ,,'•,. `�,,�1 ePTH? w SLOPE I I C YLHIV 14 15 ,........ 8 Robert A. Sha r 16- 6 17 17 Date 18 Depth to j per' ,0„ . Time 20 COMMENTS p L L O P E FA PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: CERTIFIED 72-008 (6/79) / a '7 g Date Grass Net Depth to Net ,0„ . Time Time Water Drop f PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: CERTIFIED 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST 81 19 J// ^ PERFORMED FOR:, i(- S o /l�f gacl4i e -Q DATE PERFORMED: LEGAL DESCRIPTION: -Z--[l -ry -u 2 •. r 5 s Vi •! u --------------- e /�f Cll'�• ��%!7/�� 9 �-�- 10— YA of `599rrlP ..SfL KVAS GROUND WATER �( ,I S ENCOUNTERED? i — L t O 12 O ( E 13 / ` Q� �� fj� d �J DEPTH?IF YES, WHAT SLOPE ❑ SOILS LOG ❑ PERCOLATION TEST 14 15 COMMENTS PERFORMED BY: S & S Engineering 72.008 (6/79) Reading Date Gross Time Net Time Depth to Water Net Drop lk 18 ..ri.. �. ... . i 19 imbed A. 6A dr .`; N 145 d�t'ry 20 ] •.. ,.••''c;'`'a COMMENTS PERFORMED BY: S & S Engineering 72.008 (6/79) Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DATE: JwvJ XJ This well is producingl! O gallons of water per hour. Set pump @ /15 feet. INVOICE INVOICE NO. MOON DRILLING DATE 7- _-2 -- �7 7 SR BOX 668, BOGARD RD. (�ClZlc� /! CZC�Y( J PALMER, ALASKA 99645 YOUR PO. NUMBER . TELEPHONE 7454071/ TERMS Lot BI lc.S vWLL WELL LOG SALESMAN DEPTH / CABIN FORMATION DEFT. / 11CASIN FORMATION DEPTH CABIN FORMATION IN FT. IN FT. V IN FT. V 1A A 01 701 2 102 aoa al03 aoa 4 1 44 OU 1104 .-204 -- 106 206 -6 0 Ij108 208 T 107 207 8 108 208 930B 200 10 110 710 11 111 211 2 112 ala 18 113 Z218 14 114 214 16 116 716 8 118 718 17 117 a1T le 118 218 19 11B 219 0 120 220 1121 221 2 122 _222- 28128— 72a 24 lea _224- tv 126 226 _25 as 126 226 q 127 227 e 176 228 29 12e zee so 180 230 1 iai 231 a2 ��a 282 as 283- as 18a as4 a6 laa 235 as 138 286 a 137 Tae 237 ae l ase 39 ls9 23e 40 140 -240- -42 1 141 241 47 142 247 48 148 249 44 144 244 46 146 246 46 148 248 47 147 24T 48 148 248 49 149 249 60 160 260 61 ge 791v 161 261 62 162 267 68 168 258- 54 _154— 764 66 166 266 68 168 268 67 167 767 68 168 268 6e 169 259 80 180 260- 8081161 61-161— —261 62 1e2 262 es 163 268- 64 184 764 66 las a66 88 188 288 67 167 28T 68 —168--288 89 189 —269- 70 170-270- 71 171 271 72 172 272 73 17a —278- 74 174 274 76 1 176 276 78 178 ^, .•_ 778 77 177 277 78 178 —278-.. 79 17B 278 80 1B0 280 al 161 281 82 lea ae2 =88288— 28a 84 16a 264 ee 186 286 86 les 286 87187 287 88 IBB 288 _ —89 IBB RBB B0 1B0 290 91 191 291- 92192— 287 98 198 299 9a 1e4 aea 96 196 7B6 B6 196- -2B6 97 19T 297 88 196 298- 99 19B 29B 0 200 0 PLEASE PAY FROM THIS INVOICE peet000 AMOUNT 6. LEGAL DESCRIPTION o f}/ 'J / DA76 RECEIVED INSPECTION APPOINTMENTS 8. TYPE OF RESIDENCE TIME TIME TIME ❑ Two ❑ Five DATE 4111 Three ❑ Six DATE DATE C 1 INSPECTOR ❑ PUBLIC UTILITY INSPECTOR INSPECTOR INDIVIDUAL/ON-SITE"" MUNICIPALITY OF ANCHORAGE ❑ PUBLICUTILITY MUNICIPALITY OF ANCHORAGE DEP; DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIkON,,'iN ,AL r;;i: ILCTION 826 L Street - Anchorage, Alaska 99601 0*ENVIRONMENTAL UCi 2 0 1981 SANITATION DIVISION Telephone 264.4720 ^ D FA I I I REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY J00 sA / MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BER );F If VillNei cR,6 P PHONE MAILING DDRESS 3. END NG INSTITUTION 3 /` PHONE lv MAILING ADDRESS le, !' . L O 4. REAR/AGENT ,his 04) PHONE N e V MAILING ADDRESS ((/,4 6. LEGAL DESCRIPTION o f}/ 'J / STREETLOCATION ev '4 P� 8. TYPE OF RESIDENCE NUMBER OF,BEDROOMSA* A ❑ One J�] Four E] Other DO SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY 4111 Three ❑ Six 7. WATER SUPPLY 4 INDIVIDUAL" " ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE"" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY LA__-�C�4 jD-�� 4'� - 2SlUc1' �'tM S NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 42v ht. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: / If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL A 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS LLYAPPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE gy 72-010 (Rev. 6/79) Parcel I.D. 051-361-23 R?G£ BU Municipality of Anchorage 1X On -Site Water and Wastewater Program (907)343-7904 sA Er= Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description Fire Lake, Block 3, Lot 1A Location (site address) 13810 Malaspina St. Current Property owner(s) Michael Kish & Tonya Wilson -Kish Day phone Mailing address Real Estate Agent 13810 Malaspina St. Eagle River, AK 99577 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well F Individual 0 Individual Water Storage ❑ Holding Tank ❑ Corn rpiinity �IagS Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request Received by: iii%Il 14 t&a , Date:)�IL/ COSA to be released to the engineer, unless otherwise requested by the engineer. - I COSA Fee $ 6,� .50 Waiver Fee $ _ Date of Payment 2,11 (,(1 tA JY, Date of Payment Receipt Number ()C --)l Receipt Number COSA # 01�) C l%LA I ko 51� Waiver # 5, STATEMENT OF INSPECTION BY ENGIN€ER As certified by my sea[ affixed hereto andas of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. - In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may Fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE J� System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 11/2412014 ,�.�i\•�Nj, IWOA14 %* / ........ ... . S even I2. tiring e Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: The Municilily of Ae6, rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet S ., - If more than 1 septic system is on the lot: COSA Checklist # I of Structure served by this system r Certificate of On -Site Systems Approval Checklist Legal Description: Fire Lake, Block 3, Lot 1A A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 7/25/1977 Sanitary seal (Y/N) Y Total depth 115 ft. Cased to 115 ft. Date of test Static water level Well production FROM WELL LOG 7/25/1977 Unknown ft Parcel ID: 051-361-23 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 10/31/2014 E ft. g.p.m. 3.7 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 5.64 mg/L Arsenic ND ug/L Date of sample: 10/31/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping Pumper Collected by: PES Date installed 1/25/1981 Cleanouts(Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 12/3/2014 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Shallow Trench Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 9 ft. Eff. absorption area 500 fe Monitoring tube Y Depression over Feld N Date of adequacy test New Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth New in. Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off" level at Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ MKK661614iYV Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ G. ENGINEER'S CERTIFICATION .4 �j I certify that I have determined through field inspections and rr review of Municipal records that the above systems are in 1 * conformance with MOA COSA guidelines in effect on this date. ... �`/j Engineer's Printed Name Steven R. Pannone ... t Date 12/15/2014 1�� COSA brown sheet 10-10-12.doc CE—&149 in. Municipality of Anchorage Q4 5�4 Community Development Department T §` Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 141639 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot I of Fire Lake subdivision. This inspection revealed a nitrate concentration of 5.64 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. k' N�9`s9=�o�v /B.soO ASBUILT SE6IARD & t HERE13Y CERTIFY THAT 1 HAVE SURVEYED THE SCALEr FOLLOWING DESCRIBED PROPERTY: / - 30 U�� L�'ASl/� DATE AND TNAT NO ENCROACHMEN fS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FBr ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN ARY LINES. , m �OF A mmwa��q s H �. Due.. Mark S..a,d (y r r